Is there something I should be taking to help me with my being slightly Anemic. I am findiing that I get winded just walking to my mail box...I would like to slowly start walking to build my strength up but find it too difficult to breath.

I was diagnosed just this past February. I started my cocktail on Feb 14th, it consists of Truvada, Presista, and Norvir. I just had my 1 month labs drawn and found out that in 1 month my VL went from 1 million down to 3,370 and I went from Zero T-Cells up to 160 count. This was great news but I still feel so fatigued and winded...I am 37 yrs old but completely understand how some elderly folks have to take it slow or they get winded.

what do you think I should be doing?

Response from Dr. Frascino

Hello,

Generally speaking, being "slightly anemic" wouldn't cause such significant exercise intolerance, shortness of breath and fatigue. That generally occurs with more moderate to severe anemia. How low is your hemoglobin? Regarding how anemia should be treated, that entirely depends on the underlying cause of the anemia. It could be something as simple and straightforward as a nutritional deficiency iron, vitamin B12, folate in which case supplementation would be warranted. Often the underlying cause of anemia associated with HIV/AIDS is multifactorial and more complex. The anemia could be caused by an opportunistic infection or malignancy, drug toxicity or even HIV itself (anemia of chronic disease). You can read about these and other potential causes in the archives of this forum. Your HIV doctor should evaluate the underlying cause of your anemia and then specifically treat each of the underlying conditions.

That said, I again question whether anemia is the sole cause of your current difficulty breathing. With your T-cells dropping to zero and viral load skyrocketing to one million, I would worry about an opportunistic illness, such as PCP or MAC, contributing to your problem. Certainly your response to HAART is encouraging with your CD4 count rising to 160 and viral load plummeting to 3,370. That's excellent news, but you are certainly not out of the woods yet. Hopefully you are taking prophylaxis for PCP and MAC and have been screened for CMV, toxo and other common opportunistic pathogens.

What should you be doing? You should be working closely with your HIV specialist to evaluate your current problems anemia, shortness of breath, fatigue, etc. Thorough evaluation, close follow-up and aggressive intervention are definitely warranted.

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